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Organization
PROFESSIONAL DENTAL ALLIANCE OF TX 43001 PLLC
Active
Organization
PROFESSIONAL DENTAL ALLIANCE OF TX 43001 PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAUREN HOWARD (CREDENTIALING SPECIALIST)
(757) 576-5479
Entity
Organization
Contact information
Practice address
1205 W MCDERMOTT DR STE 120, ALLEN, TX 75013-6302
(214) 305-2642
Mailing address
11 S MILL ST, NEW CASTLE, PA 16101-3680
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
08/27/2020
Last updated
08/27/2020
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